Can a health service tackle a pandemic and transform itself at the same time?
If the HSE’s corporate plan for 2021-2024 delivers on its promises nobody will wait more than 12 weeks on a hospital waiting lists and any older person who wants to live at home can do so.
It is full of aspirational objectives across a range of areas including mental health, disability and lifestyle diseases.
The basics are built around Sláintecare – the consensus blueprint which was signed off to end the two-tier system.
So will it work?
Expectations must always be tempered when it comes to the HSE which since it was set up has failed to deliver in so many areas.
Officials were optimistic yesterday that changes which Covid-19 ushered in with more care in the community to reduce people’s dependence on hospitals will give them a head start.
The pandemic has speeded up changes which might have taken some tortuous years otherwise.
However, these changes – such as the investment in home care supports – were made possible by huge levels of Government funding which were pumped into the service to cope with the pandemic emergency.
If that is a silver lining then the dark cloud is the grim mess that the pandemic is leaving behind.
The number of people on hospital waiting lists is heading for a million and an analysis yesterday said that almost the same number of appointments will be cancelled over last year and 2021.
The HSE is already playing catch up and patients are languishing in a huge backlog.
It plans to implement “elective-only centres” although it is unclear where these are. The last Government planned new hospitals which would only care for waiting list patients but this is not included.
More public patients will be sent to private hospitals. There is yet another capacity review to see where there are gaps in beds and theatres.
There is no overt mention of phasing out private practice in public hospitals which was at the core of the Sláintecare plan.
There is little gritty detail about changing work practices. And much will depend on having more of the right staff.
The price tag is enormous. It needs €1.2bn extra year at a minimum. And a further €500m is needed for each year as once-off transitional funding.
At the same time it concedes the pressure on the country’s finances as well as the costs of Covid-19 will continue to be a burden.
Time is running out and this plan must work for the thousands of people who are suffering for want of treatment and care.
The pandemic came on top of a struggling health service and it has left many people who were already getting a poor deal worse off.